Physiological and exogenous hormonal fluctuations across the female lifespan impact the QT interval and arrhythmia risk in women with long QT syndrome, with potential genotype-specific differences.
How do physiological and exogenous hormonal fluctuations impact the QT interval and arrhythmia risk in women with long QT syndrome?
Hormonal fluctuations across the female lifespan significantly impact QT interval variability in women with LQTS, necessitating individualized risk stratification and management.
Sex-related differences in the QT interval become evident from puberty through menopause. Sex steroid hormones have been suggested to play a role in cardiac repolarization, although their impact remains a matter of debate. These effects are especially pronounced in women with inherited long-QT syndrome (LQTS), and may face a higher risk of QT variability associated with endogenous or exogenous hormonal fluctuations. This narrative review aims to summarize the impact of physiological hormonal fluctuations on QT interval in LQTS women across the female lifespan, including menstrual cycle, pregnancy and postpartum, menopause, and concluding with exogenous hormonal administration such as oral contraceptives, and ovarian stimulation in assisted reproductive technologies (ART), highlighting potential genotype-specific differences. Insights gained from this review may inform more precise risk stratification, optimize individualized management, and improve safety for women with LQTS across their reproductive lifespan.
Greco et al. (2026) conducted a review in Long QT syndrome. Sex hormones (endogenous and exogenous) was evaluated on QT interval and arrhythmia risk. Physiological and exogenous hormonal fluctuations across the female lifespan impact the QT interval and arrhythmia risk in women with long QT syndrome, with potential genotype-specific differences.
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